Erythropoietin (EPO): A synthetic version of this naturally occurring hormone is used by cheating athletes to boost red blood cell counts, a change that temporarily supercharges endurance by increasing muscles' oxygen-carrying capacity. Before 2000, no test existed to distinguish the synthetic version of the hormone from its natural counterpart, so as long as athletes took doses that would keep their hematocrit (a measure of the volume percentage of blood made up of red blood cells) in a plausible range (below 50 percent), they could use this drug with impunity. And the report alleges that Armstrong's pre-2000 team did just that, fueling its 1999 Tour de France win.
But the USADA also claims that Armstrong's abuse of EPO didn't stop after the introduction of a urine test capable of detecting the drug in 2000; it merely took a more covert form. Conspiring doctors, the report alleges, instructed Armstrong and his teammates to inject EPO intravenously (as opposed to subcutaneously, or into an inner layer of skin) and at night, when surprise tests were unlikely. These measures would make it possible for low doses of synthetic EPO to be cleared from a rider's system by the time he woke.
In situations where EPO tests on recently dosed athletes were unavoidable, team doctors also could have injected saline, or salt water, to dilute a rider's blood and quickly drive down hematocrit. This kind of obfuscating saline injection was a common practice for Armstrong and his team, according to the USADA report.
I'd like to hear more of that: how much fluid could you reasonably inject? The human body has two *gallons* of blood; and the chance of throwing off the electrolyte balance and/or bloating might well outweigh the temporary advantage of a dose of EPO so small that it was cleared by morning anyway.
Face it, Lance survived Stage 4 cancer: and enduring that treatment probably made the Alpe d'Huez seem like a joke by comparison.
Cheers!